Feyikemi Faniyi

Individual provider Active NPI Registered Nurse · Roosevelt, NY

NPI 1760065007 · NPPES record last updated May 4, 2021

Key facts

NPI
1760065007
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
814186 (NY)
Practice address
109 Mirin Ave
Roosevelt, NY 11575-1619
Phone
(347) 828-2135
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
814186NYMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 814186 NY Yes

Addresses

Primary practice location

109 Mirin Ave
Roosevelt, NY 11575-1619

Mailing address

109 Mirin Ave
Roosevelt, NY 11575-1619
Phone (347) 828-2135

Other providers in Roosevelt, NY

All providers in Roosevelt, NY · Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.